Antidepressants Pose Cataract Risk
The first major study on this topic has shown an increased risk among seniors of developing cataracts as a result of taking the most common type of antidepressant – SSRIs.
SSRIs, or selective serotonin reuptake inhibitors, alleviate depression by raising low levels of serotonin in the brain. But the eye’s lens also contains serotonin receptors and excess serotonin can make the lens opaque and lead to cataract formation, reports the Canadian research, which included 19,000 patients who were on at least one of these drugs and 190,000 controls, meaning people who were not.
The risk was related only to current use, meaning risk disappeared after discontinuation of the antidepressants.
There is an additional higher risk of corneal damage from amantadine, a Parkinson’s disease drug. Parkinson’s patients on long-term amantadine therapy were found to have cornea changes that could lead to vision damage.
The study appears in the June, 2010 issue of Opthalmology (see abstract below).
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ARTICLE ABSTRACT
Selective Serotonin Reuptake Inhibitors and the Risk of Cataracts A Nested Case-Control Study.
Etminan M, Mikelberg FS, Brophy JM.
Ophthalmology. 2010 Mar 6. [PMID: 20207418]
Center for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, Canada; Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
OBJECTIVE: Older-generation antidepressants have been associated with increasing the risk of cataracts. Although animal studies have alluded to a potential link between selective serotonin reuptake inhibitors (SSRIs) and the development of cataracts, no large population based-study has addressed this potential association. This study sought to quantify the risk of cataracts with SSRIs by conducting a pharmacoepidemiologic study using the linked administrative databases in the province of Quebec, Canada.
DESIGN: Nested case-control study.
PARTICIPANTS: A cohort of subjects who had received a coronary revascularization procedure from 1995 through 2004 in the province of Quebec, Canada. METHODS: Using an administrative data set, a case-control study was conducted within a cohort of Quebec residents who had received a coronary revascularization procedure from 1995 through 2004. Cases were defined as those with the first diagnosis of a cataract diagnosed by an ophthalmologist. For each case, 10 controls were selected and matched to the cases by index date, age, and cohort entry. Crude and adjusted rate ratios (RRs) and corresponding confidence intervals (CIs) were computed for current use of SSRIs. Rate ratios were adjusted for gender, corticosteroid use, statins, high blood pressure, antihypertensives, and antidiabetics.
MAIN OUTCOME MEASURES: First International Classification for Disease (Ninth Revision) code for a cataract diagnosed by an ophthalmologist. RESULTS: Eighteen thousand seven hundred eighty-four cases and 187 840 controls met our study inclusion criteria. The adjusted RR for cataracts among current users of SSRIs was 1.15 (95% CI, 1.08-1.23). The risk of cataracts was highest with fluvoxamine (RR, 1.39; 95% CI, 1.07-1.80), followed by venlafaxine (RR, 1.33; 95% CI, 1.14-1.55) and paroxetine for cataract surgery (RR, 1.23; 95% CI, 1.05-1.45). The average time to diagnosis of cataracts while on SSRI therapy was 656 days. CONCLUSIONS: A possible association was found between current exposure to SSRIs, especially fluvoxamine and venlafaxine, and a future diagnosis of cataracts. The possibility that this observation may be the result of the effect of smoking, which could not be controlled for in the study, cannot be excluded. Future studies are needed to confirm this association in other populations. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article. Copyright © 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
PMID: 20207418
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